This case study demonstrates the theory of change working in practice. Through their engagement with their communities and alignment with the sector, the Tasmanian Council on AIDS, Hepatitis, and Related Diseases (TasCAHRD) was able to achieve increased reach, increased effectiveness, and stronger partnerships – all of which, led to better outcomes for their communities.
High-quality health promotion work is built on a strong evidence base that demonstrates the needs and the strengths of the community. While the Tasmanian Council on AIDS, Hepatitis, and Related Diseases (TasCAHRD)’s engagement with Lesbian, Gay, Bisexual, Trans, Intersex and Queer (LGBTIQ) communities means they have a deep understanding of community needs, this knowledge is strengthened by integrating academic research. Until recently, however, the Gay Community Periodic Survey (which has been conducted regularly in mainland states and territories since 1996) was not available in Tasmania, meaning there was a lack of data for the State on trends in sexual practices and HIV transmission.
In 2014, the Centre for Social Research in Health (CSRH) at the University of New South Wales collaborated with TasCAHRD to conduct the survey in Tasmania for the first time (alignment), demonstrating that TasCAHRD is seen as a credible organisation that is able to reach HIV-affected communities. The survey was repeated in 2016, and showed that many men who have sex with men (MSM) in Tasmania had never been tested for HIV, and there was a high rate of condomless sex with casual partners.
TasCAHRD identified the need for more information about the barriers and incentives for HIV testing, prevention and treatment for MSM. They responded to this gap by partnering with the Centre for Social Research and Health (stronger partnerships) to undertake further research and they secured funding from the Tasmania Government’s LGBTIQ Grant Program to support the project (responsive).
The qualitative research1 aimed to understand the barriers to HIV prevention and care among gay and bisexual men, focusing on experiences of homosexuality and HIV-related stigma and discrimination.
TasCAHRD used its existing communication channels within gay communities in Tasmania to recruit participants, including social media and their Man2Man magazine. Their embeddedness in the community (engagement) enabled TasCAHRD to reach and recruit a diverse group of men for the research.
TasCAHRD identified the importance of providing a culturally safe experience so participants would feel comfortable openly sharing their experiences without fear of judgement or discrimination. To achieve this, TasCAHRD utilised their staff and volunteers who are part of the gay community in Tasmania to conduct the interviews (peer service delivery). The Centre for Social Research and Health provided training and technical support to the staff, which ensured that the research was valid and credible, thereby increasing its value to the sector.
The interviews explored a range of deeply personal topics such as experiences of stigma and discrimination, personal strategies for maintaining sexual health, experiences living as a gay or bisexual and/or HIV-positive man. The willingness of participants to share such personal information with the organisation demonstrates the high degree of trust that TasCAHRD has cultivated over the last 30 years.
This successful alignment with the academic sector has enabled TasCAHRD to provide evidence-based policy advice, which increases their credibility in the sector, and ensures that their health promotion programs are relevant to the specific needs of their local community and address the community’s particular challenges and barriers to reducing HIV transmission (increased effectiveness).
